Objective To investigate the change of apoptosis and drug resistance after multiple thermotherapy On the HepG2 Cell. Methods After HepG2 cell were treaded by ten repeated cycles of exposure at 43 degree C for 80 minutes twice a day，the sensibility of HepG2 cell to Adfiamyein was analyzed by MTr assay.The apoptosis Was detected by kit，and the expression of Bcl-2 or Bax protein and mRNA were detected by immunohistochemical method and RT-PCR respective.Results The drug resistance to Adfiamycin Was gained by HepG2 cell after multiple thermotherapy.The rate of apoptosis was decreased，the expression of Bcl一2 protein and mRNA Was strengthened，and the ratio of Bcl-2/Bax increased.Conclusions The resistance of heated HepG2 cell to chemotherapeutics Was related with the decreased rate of apoptosis，overexpression of Bcl-2 protein and mRNA，and increased ratio of Bcl-2/Bax.

Objective To evaluate the clinical efficacy after implantation of preloaded aspheric intraocular lens.Design Retrospective case series.Participants 74 patients(82 eyes)with age-related cataract:38 patients(43 eyes)in group A(control group),36 patients(39 eyes)in group B(case group).Methods 74 patients(82 eyes)were randomly selected to receive phacoemulsification with KS-3(group A)and KS-3Ai(group B)IOL implantation.The wavefront aberrations and contract sensitivity were measured 3 months post-operatively.Main Outcome Measures Wavefront aberrations and contract sensitivity.Results No complications occurred in both gruops.In 1.0deg,0.7deg,the mean contract sensitivity in group A were lower than those in group B(t =3.69,2.71;P

OBJECTIVE:To study invalid medical order warned by Prescription automatic screening system (PASS),and to improve rational drug use monitoring. METHODS:The infusion medical order warned with black light,red light and orange light by PASS were extracted from Pharmacy intravenous admixture services(PIVAS)of our hospital during Oct. to Dec. 2014. Invalid warning items were analyzed statistically in respect of warning level,problem types and reasons. RESULTS & CONCLUSIONS:There are 3 392 warnings items,468 were invalid (13.80%) which include 10 items by black light,219 items by red light and 239 items by orange light;by problem types,there are 218 items of overdose and 136 items of repeated treatment,etc. The main causes of invalid warning include 191 items caused by wrong system prompt,126 items by incomplete system information,143 items by insufficient auditing standards,etc. There are still some defects of invalid warning in practical application of PASS. It is suggested that user and developer add the function of self-defined drug list or user-defined system data by,and unify auditing stan-dards of rational drug use,etc.,so as to timely update the system information,and improve the accuracy of software system moni-toring and warning function.

Objective To study the incidence of ventilator-associated pneumonia(VAP)and antimicrobial resistance of pathogens in an intensive care unit(ICU).Methods The occurrence of VAP in hospitalized patients with mechan-ical ventilation>48 hours between January 2011 and December 2012 were investigated,species and antimicrobial re-sistance of pathogens causing early onset-VAP (E-VAP,mechanical ventilation≤4 d)and late-onset VAP(L-VAP, mechanical ventilation>4 d)were compared.Results A total of 1 76 patients were investigated,incidence of VAP was 44.32% (78 cases);With the prolongation of mechical ventilation,incidence of VAP increased gradually (χ2=52.561,P<0.001).The incidence of L-VAP was significantly higher than E-VAP (58.33% [70/120]vs 14.29%[8/56])(χ2= 30.02,P<0.001).A total of 178 pathogens were isolated,gram-negative bacteria,gram-positive bac-teria and fungi were 104(58.43% ),46(25.84% ),and 28(15.73% )isolates respectively;97(54.49% )multidrug-resistance/pandrug resistance organisms (MDRO)were isolated. MDRO isolation rate in L-VAP patients was high-er than E-VAP patients([58.86% ,n= 93]vs [20.00% ,n= 4]),resistance rate of major pathogens causing L-VAP was significantly higher than E-VAP patients(allP<0.05).Fungi infection only occurred in L-VAP patients,the total antimicrobial resistance rate was 12.14% .Conclusion The prolongation of mechanical ventilation can increase the incidence of VAP,and resistance rate of pathogen in L-VAP is high.

Objective To improve patient postoperative comfort of vitrectomy with tamponnade in the prone position, design a new prone position headrest to reduce complications caused by improper body position and observe its clinical effect. Methods According to the postoperative position of the patients, 360 cases were collected. The patients were divided into the control group and the observation group with 180 cases of each group. Observation group was treated with the new prone position headrest nursing, control group were treated with routine prone position. The comfort of patients, postoperative adverse reactions, success rate of retina reattachment were observed. Results According to simplified comfortable situation scale, physiological, psychological, social culture and environment of each individual score respectively was (2.74±0.21), (3.54±0.29) , (3.25±0.23), (3.36±0.27) points in observation group and (2.30± 0.19), (2.92±0.31), (2.93±0.26), (2.79±0.30) points in control group, and there were significant differences (t=12.368-20.845, all P<0.05). The daily posture duration in postoperative first time and 5 days was respectively (220.00±25.08), (1008.00 ± 20.32) min in observation group and (85.00±28.07), (650.00± 30.12) min in control group, and there were significant differences(t=48.117, 133.194, all P<0.01). The incidence of corneal edema, conjunctival congestion, water turbidity in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (U=6.308,8.130, 6.875, P < 0.01). The incidence of high intraocular pressure, recurrent retinal detachment rate and reduction rate in observation group were lower than those in control group at 4 weeks after surgery, and there were statistically significant difference (χ2=9.000, 10.540, 11.770, P < 0.01). Conclusions The new prone headrest can effectively improve the resection of vitreous body with tamponade patients in comfort, ensure the operation effect.

Objective To investigate the expression change of ghtathione S-transferase π(GSTπ)protein and mRNA in the HepG2 cell after multiple thermotherapy.Methods HepG2 cells were treaded by ten repeated cycles of exposure at 43 degree C for 80 minutes twice a day，the sensibility of HepG2 cell to Adriamycin was analyzed by MTr assay，and the expression of QSTπprotein and mRNA were detected by immunohistochemical method and RT-PCR.Results The drug resistance to Adriamycin was gained by HepG2 cells after multiple thermotherapy，and the expression of GSTπ protein and mRNA wag strengthened.Conclusions The resistance of heated HepG2 cells to chemotherapeutics was concerned with overexpression of GSTπ protein and mRNA.

Objective To observe multimodal imaging characteristics in eyes with focal choroidal excavation (FCE) and preliminarily analyze the risk factors in FCE with complications correlated with RPE.Methods A retrospective case series.Thirty-one patients (31 eyes) with monocular FCE,first identified by spectral-domain (SD)-OCT in the Eye Center of The Second People's Hospital of Foshan from December 2014 to December 2018,were involved in this study.There were 14 males and 17 females,with the mean age of 45.84± 13.57 years.All patients underwent BCVA,optometry,and SD-OCT examinations.FFA and ICGA were simultaneously performed in 3 FCE patients with RPE complications.The subfoveal choroidal thickness (SFCT) and excavation width were measured with enhanced depth imaging OCT (EDI-OCT).The eyes with FCE were divided into two groups (FCE alone group 17 eyes vs.FCE complication group 14 eyes),based on whether complicated by RPE dysfunction.Among 14 eyes of FCE complication group,7 (22.6％) with choroidal neovascularization,4 (12.9％) with central serous chorioretinopathy,1 (3.2％) with polypoidal choroidal vasculopathy,and 2 (6.5％) with RPE detachment.No significant difference was found in the mean age (t=0.87),gender composition (x2=0.06),ocular laterality (x2=2.58),and spherical equivalent (t=-0.81) between two groups,respectively (P＞0.05),except that the BCVA was significantly different (t=-2.11,P＜0.05).The SFCT and excavation width of eyes in both groups and the ICGA imaging characteristics of eyes in FCE complication group were analyzed.Risk factors of FCE with RPE complications were analyzed by logistic regression analysis.Results Thirty-three excavations were identified in 31 eyes with FCE.The mean SFCT was 167.00± 85.18 μm in FCE alone group vs.228.36± 67.95 μm in FCE complication group,while the excavation width was 645.00 ± 231.93 μm vs.901.00± 420.55 μm and they were both significantly different (P＜0.05).Logistic regression analysis showed the SFCT (OR=1.016,P=0.026) and excavation width (OR=1.004,P=0.034) were risk factors for RPE complications of FCE.EDI-OCT showed the RPE at the excavation was impaired or vulnerable in all eyes of the FCE alone group,especially at the boundary area of excavation.The RPE damages were located at the boundary area of excavation in 10 eyes (71.4％) of FCE complication group.Constant choroidal hypofluorescence and filling defect were observed under the excavation in 3 eyes with ICGA imaging.Conclusions SFCT and excavation width may be risk factors for RPE complications of FCE.Impairment of RPE at boundary area of excavation and focal choroidal ischemia or aberrant circulation under the excavation may correlate with the development of FCE complications.

Objective:To evaluate the advantages of cortical perichondrium retention of costal cartilage in tip plasty.Methods:A total of 618 female cases were retrospectively analyzed from July 2017 to July 2018 in Zhengzhou Meilai Medical Beauty Hospital that underwent comprehensive line of rib cartilage rhinoplasty for beauty, aged 18-52 years with mean 27±6 years. According to different modification graft used in plasty, the cases were divided into reserve costal perichondrium cortex group (experimental group) and simple rib cartilage cortex group (control group). Statistical analyses were carried out 1 month and 12 months after operation. The tip displacement visualization was compared between the two groups and the advantages and disadvantages were evaluated in both.Results:After the surgery of the 618 patients, the rate of displacement in the experimental group was 3.6%, and that in the control group was 7.9% (χ 2=4.95, P<0.05). The rate of the implant exposure in the experimental group was 4.7%, and that in the control group was 9.1% (χ 2=4.38, P<0.05). The reserve costal perichondrium cortex used in the nasoplasty kept the prominent and stable nasal tip after the operation, and longterm follow-up showed there were no displacement and deformation occured in the patients. Conclusions:The application of costal cartilaginous cortex retaining costal perichondrium in tip plasty can obtain good nasal tip protrusion and stable rotation. It is an ideal nasal tip shaping material and worthy of clinical application.

Objective:To evaluate the clinical effect of remodeling the dense dermal fiber structure in the suprapical region on the correction of nasal hypertrophy.Methods:A retrospective analysis was carried out in beauty-seeking patients who underwent comprehensive costal cartilage rhinoplasty with nasal hypertrophy in our hospital from September 2016 to February 2018. The technique of horizontal scratch reconstruction and deep dermal suture fixation at the tip of the nose was used to fix the dense fibrous dermal fiber structure in the suprapical area. Photos were followed up 12 months after the operation to observe whether the suprapical area had arch and upward displacement of the nasal tip.Results:All patients healed primarily, and the patients were satisfied with the effects. Follow-up results showed that only one female patient showed upshift of nasal tip after surgery among the 57 patients with hypertrophy of nasal tip for beauty. The remaining 56 patients had no upward movement of the nose tip and arching of the upper turning area.Conclusions:By reshaping the dense dermal fiber structure of the suprapical area, the suprapical area of the patients who seek beauty after the operation will have a natural transition, beautiful shape and stable nasal structure.

ObjectiveTo investigate the causal association of liver function and lipid metabolism levels with sleep disorders based on the Mendelian randomization analysis. MethodsThe analysis was conducted using the data from genome-wide association studies， with the exposure factors of liver function and lipid metabolism levels （alanine aminotransferase ［ALT］， aspartate aminotransferase ［AST］， gamma-glutamyl transpeptidase ［GGT］， albumin ［Alb］， serum total protein ［TP］， total bilirubin ［TBil］， alkaline phosphatase ［ALP］， triglyceride ［TG］， triglyceride-to-glycerol-3-phosphate ［TG/G3P］ ratio， total cholesterol ［TC］， high-density lipoprotein cholesterol ［HDL-C］， low-density lipoprotein cholesterol ［LDL-C］， poly-unsaturated fatty acids ［PUFA］， total fatty acids ［TFA］， PUFA/TFA ratio） and the outcome factor of sleep disorders （nonorganic）. The regression models including inverse variance weighted， MR-Egger， Simple mode， weighted median， and Weighted mode were used to perform the Mendelian randomization analysis. ResultsSerum Alb （odds ratio ［OR］=0.728， 95% confidence interval ［CI］： 0.535 ‍—‍‍ 0.989， P<0.05）， HDL-C （OR=0.879， 95%CI： 0.784 ‍—‍ 0.986， P<0.05）， and PUFA/TFA ratio （OR=0.800， 95%CI： 0.642 — 0.998， P<0.05） were negatively associated with sleep disorders， while TG/G3P ratio （OR=1.222， 95%CI： 1.044 ‍—‍ 1.431， P<0.05） was positively associated with sleep disorders. The results of Mendelian randomization did not show a causal association of ALT， AST， GGT， TP， TBil， ALP， TG， TC， LDL-C， PUFA， and TFA with sleep disorders （all P>0.05）. The results of the MR-Egger intercept test showed no pleiotropy （P>0.05）， and Mendelian randomization was a valid method for causal inference in this study. ConclusionAccording to the results of the Mendelian randomization analysis， liver function and lipid metabolism show significant association with sleep disorders. Liver function and lipid metabolism can be used as indicators for predicting the risk of sleep disorders and performing intervention.